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Original Contribution
JAMA. 2003;290(18):2443-2454. doi: 10.1001/jama.290.18.2443

Lost Productive Time and Cost Due to Common Pain Conditions in the US Workforce

  1. Walter F. Stewart, PhD, MPH;
  2. Judith A. Ricci, ScD, MS;
  3. Elsbeth Chee, ScD;
  4. David Morganstein, MS;
  5. Richard Lipton, MD
  1. Author Affiliations: AdvancePCS Center for Work and Health, Hunt Valley, Md (Drs Stewart, Ricci, and Chee); Geisinger Health Systems, Danville, Pa (Dr Stewart); Statistical Group, Westat, Rockville, Md (Mr Morganstein); and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (Dr Lipton).

Abstract

Context  Common pain conditions appear to have an adverse effect on work, but no comprehensive estimates exist on the amount of productive time lost in the US workforce due to pain.

Objective  To measure lost productive time (absence and reduced performance due to common pain conditions) during a 2-week period.

Design and Setting  Cross-sectional study using survey data from the American Productivity Audit (a telephone survey that uses the Work and Health Interview) of working adults between August 1, 2001, and July 30, 2002.

Participants  Random sample of 28 902 working adults in the United States.

Main Outcome Measures  Lost productive time due to common pain conditions (arthritis, back, headache, and other musculoskeletal) expressed in hours per worker per week and calculated in US dollars.

Results  Thirteen percent of the total workforce experienced a loss in productive time during a 2-week period due to a common pain condition. Headache was the most common (5.4%) pain condition resulting in lost productive time. It was followed by back pain (3.2%), arthritis pain (2.0%), and other musculoskeletal pain (2.0%). Workers who experienced lost productive time from a pain condition lost a mean (SE) of 4.6 (0.09) h/wk. Workers who had a headache had a mean (SE) loss in productive time of 3.5 (0.1) h/wk. Workers who reported arthritis or back pain had mean (SE) lost productive times of 5.2 (0.25) h/wk. Other common pain conditions resulted in a mean (SE) loss in productive time of 5.5 (0.22) h/wk. Lost productive time from common pain conditions among active workers costs an estimated $61.2 billion per year. The majority (76.6%) of the lost productive time was explained by reduced performance while at work and not work absence.

Conclusions  Pain is an inordinately common and disabling condition in the US workforce. Most of the pain-related lost productive time occurs while employees are at work and is in the form of reduced performance.

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